Rogue Internet pharmacies should be primary focus in efforts to secure supply chain

A House Subcommittee on Health hearing Thursday focused on efforts to strengthen the country's pharmaceutical supply chain, and particularly on draft legislation meant to accomplish that.

While often touted as the safest in the world, the U.S. drug supply chain remains vulnerable to counterfeit, adulterated and stolen medications. Given the potentially dangerous risks of using such medicines, it is imperative that they be kept out.

But as testimony by National Community Pharmacists Association spokesman and pharmacy owner Tim Davis, as well as statements by Republican Rep. Morgan Griffith of West Virginia made clear, requiring community pharmacies to implement complicated and expensive track-and-trace technology would place a tremendous burden on them — specially independents.

In Davis' words: "At the present time, the technologies that would be required to implement such a system are not fully developed and have not been designed or scaled to be feasible or affordable for use in individual community pharmacies."

But a major source of counterfeit, stolen and adulterated drugs isn't the corner drug store, but online pharmacies. On Tuesday, the Food and Drug Administration launched BeSafeRx, an interactive map on its website that allows users to find legitimate online pharmacies licensed by state boards of pharmacy. Such a tool could be useful because, according to a report released in October 2012 by the National Association of Boards of Pharmacy that examined more than 10,000 online drug sellers, 97% were found to be doing business illegally.

The dangers of such rogue pharmacies can't be overstated: In May 2012, the FDA alerted consumers about fake versions of Teva's attention deficit hyperactivity disorder drug Adderall (dextroamphetamine saccharine; amphetamine aspartate; dextroamphetaine sulfate; amphetamine sulfate) that were being purchased online amid a shortage at the time. The fake version contained the wrong active ingredients, specifically tramadol and acetaminophen, which are used to treat acute pain. It's worth noting that while approved by the FDA for treating ADHD, Adderall is also a common target for prescription drug abuse.

As Davis said, most pharmacists are well-aware of the possibility of counterfeit and diverted drugs and thus purchase only from trusted sources. For that reason, the federal government might have more success keeping such contraband out of the country by thwarting the efforts of rogue Internet pharmacies and encouraging consumers to avoid them as well. Efforts like BeSafeRx and the National Association of Boards of Pharmacy's campaign to register .pharmacy as a top-level domain reserved for licensed online pharmacies are both steps in that direction — not forcing community pharmacies to devote disproportionate resources to solving a problem that isn't really about them.